IPHREHAB : INFECTION, TYPHOID

IPHREHAB

TYPHOID

• Very common disease in our country
• Outbreaks are known to occur from time to time
• Pollution & Insanitary condition
• Present in animals except S.Typhi
• Transmitted by food, water, Milk
•  May be directly from one person to another

AETIOLOGY

• Caused by Salmonella Group of Organisms
• Reservoir are animals except for S.Typhi which is seen only in human beings
• There are 2000 Serotypes
• Faeco-oral route
• Tranmission through food, Flies & Fomites
• It involves Payer’s patches of small Intestines

CLINICAL PICTURE

• Fever is most common presenting symptom
• Fever is step ladder pattern
• Onset is insidious
• There is Malaise, Headache, Cough,  Drowsiness & Bodyaches
• Constipation common
• Relative Bradycardia
• Rash may appear on fifth day
• Toxaemia is Max. in 2nd Week
• Spleen is palpable
• Toxaemia increases in 3rd Week
• Coma may set in & may lead to death
• Antibiotics give the best results
• Carriers are well known

INVESTIGATIONS

• Complete Blood Leukopenia Increase in Lympho
• Blood Culture +ve  first week
• Widal’s  Test  2nd Week Rising titer is diagnostic
• Urine & Stool Culture

COMPLICATIONS

• Perforation
• Haemorrhage
• Osteomyelitis
• Meningitis
• Myocarditis
• Pneumonia
• Nephritis
• Hepatitis

MANAGEMENT

• General Management :- Analgesics for fever, Antiemetics (Perinorm) for vomiting
• Antibiotics Ciproflxacillin 500mg BD
• Cotrimoxazole 
• Amoxycillin
• Carrier Ciproflox for 4 weeks
• Prevention - Vaccination